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Sex and the mission: the conflicting effects of early Christian missions on HIV in sub-Saharan Africa

Published online by Cambridge University Press:  22 September 2020

Julia Cagé  and
Valeria Rueda Open the ORCID record for Valeria Rueda [Opens in a new window]
Julia Cagé
Affiliation:
Sciences Po Paris and CEPR, Paris, France
Valeria Rueda*
Affiliation:
School of Economics, University of Nottingham, Nottingham, UK
*
*Corresponding author. E-mail: [email protected]
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Abstract

This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection.

Keywords

AfricaChristianityhealthcare infrastructurehistorical persistenceHIV/AIDSmissionssexual behaviors

JEL classification

N37: Africa • Oceania Z12: Religion Z13: Economic Sociology • Economic Anthropology • Language • Social and Economic Stratification D72: Political Processes: Rent-Seeking, Lobbying, Elections, Legislatures, and Voting Behavior N77: Africa • Oceania
Type
Research Papers
Information
Journal of Demographic Economics , Volume 86 , Special Issue 3: The Economics of Religion , September 2020 , pp. 213 - 257
Copyright
Copyright © Université catholique de Louvain 2020

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